Pruritus pp 301-306 | Cite as

Psychosomatic Aspects and Psychiatric Conditions

  • Gudrun SchneiderEmail author


This chapter elucidates psychosomatic aspects of pruritus in healthy persons, in pruritic dermatologic skin diseases and in symptomatic pruritus. It reports the research findings on the role of personality aspects, stressful life events and some psychophysiologic and psychoneuroimmunologic aspects of pruritus. It also discusses developmental, social and behavioural aspects. In the second part it gives a systematic of psychiatric conditions and psychic disorders associated with pruritus: (A) Chronic itching as a symptom of psychic disorders; (B) Multifactorially induced itching, the onset and course of which may be considerably influenced by psychic factors; (C) Psychic disorders as a result of chronic itching and (D) Co-morbidity with psychic disorders. Frequency of psychic disorders in patients with chronic pruritus is high and some psychotherapeutic approaches are presented.


Chronic pruritus Chronic itch Psychosomatic aspects Personality Life events Stress Psychic disorders Systematic Psychotherapeutic approach 


  1. 1.
    Niemeier V, Kupfer J, Gieler U. Observations during an itch-inducing lecture. Dermatol Psychosom. 2000;1 suppl 1:15–8.Google Scholar
  2. 2.
    Ogden J, Zoukas S. Generating physical symptoms from visual cues: an experimental study. Psychol Health Med. 2009;14(6):695–704.CrossRefPubMedGoogle Scholar
  3. 3.
    Papoiu AD, Wang H, Coghill RC, Chan YH, Yosipovitch G. Contagious itch in humans: a study of visual ‘transmission’ of itch in atopic dermatitis and healthy subjects. Br J Dermatol. 2011;164(6):1299–303.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Lloyd DM, Hall E, Hall S, McGlone FP. Can itch-related visual stimuli alone provoke a scratch response in healthy individuals? Br J Dermatol. 2013;168(1):106–11.CrossRefPubMedGoogle Scholar
  5. 5.
    Ward J, Burckhardt V, Holle H. Contagious scratching: shared feelings but not shared body locations. Front Hum Neurosci. 2013;7:122–3.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Schut C, Grossman S, Gieler U, Kupfer J, Yosipovitch G. Contagious itch: what we know and what we would like to know. Front Hum Neurosci. 2015;9:57–62.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Schneider G, Gieler U. Die Haut als Spiegel der Seele. Psychosomatische Dermatologie – aktueller Forschungsstand. Z Psychosom Med Psychother. 2001;47:307–31.PubMedGoogle Scholar
  8. 8.
    Schut C, Bosbach S, Gieler U, Kupfer J. Personality traits, depression and itch in patients with atopic dermatitis in an experimental setting: a regression analysis. Acta Derm Venereol. 2014;94(1):20–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Holle H, Warne K, Seth AK, Critchley HD, Ward J. Neural basis of contagious itch and why some people are more prone to it. Proc Natl Acad Sci U S A. 2012;109(48):19816–21.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Carr CW, Veledar E, Chen SC. Factors mediating the impact of chronic pruritus on quality of life. JAMA Dermatol. 2014;150(6):613–20.CrossRefPubMedGoogle Scholar
  11. 11.
    Schut C, Muhl S, Reinisch K, Claßen A, Jäger R, Gieler U, Kupfer J. Agreeableness and self-consciousness as predictors of induced scratching and itch in patients with psoriasis. Int J Behav Med. 2015;22:726–34.CrossRefPubMedGoogle Scholar
  12. 12.
    Dalgard F, Stern R, Lien L, Hauser S. Itch, stress and self-efficacy among 18-year-old boys and girls: a Norwegian population-based cross-sectional study. Acta Derm Venereol. 2012;92(5):547–52.CrossRefPubMedGoogle Scholar
  13. 13.
    Yamamoto Y, Hayashino Y, Yamazaki S, Akiba T, Akizawa T, Asano Y, Saito A, Kurokawa K, Miyachi Y, Fukuhara S, J-DOPPS Research Group. Depressive symptoms predict the future risk of severe pruritus in haemodialysis patients: Japan Dialysis Outcomes and Practice Patterns Study. Br J Dermatol. 2009;161(2):384–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Gupta MA, Gupta AK. Stressful major life events are associated with a higher frequency of cutaneous sensory symptoms: an empirical study of non-clinical subjects. J Eur Acad Dermatol Venereol. 2004;18:560–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Gupta MA, Gupta AK, Kirkby S, Weiner HK, Mace TM, Schork NJ, Johnson EH, Ellis CN, Voorhees JJ. Pruritus in psoriasis. A prospective study of some psychiatric and dermatologic correlates. Arch Dermatol. 1988;124:1052–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Stangier U, Gieler U. Somatoforme Störungen in der Dermatologie. Psychotherapie. 1997;2:91–101.Google Scholar
  17. 17.
    Kodama A, Horikawa T, Suzuki T, Ajiki W, Takashima T, Harada S, Ichihashi M. Effect of stress on atopic dermatitis: investigation in patients after the great Hanshin earthquake. J Allergy Clin Immunol. 1999;104:173–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Gieler U, Niemeier V, Brosig B, Kupfer J. Psychosomatic aspects of pruritus. Dermatol Psychosom. 2002;3:6–13.CrossRefGoogle Scholar
  19. 19.
    Mitschenko AV, Lwow AN, Kupfer J, Niemeier V, Gieler U. Atopic dermatitis and stress? How do emotions come into skin? Hautarzt. 2008;59:314–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Oh SH, Bae BG, Park CO, Noh JY, Park IH, Wu WH, Lee KH. Association of stress with symptoms of atopic dermatitis. Acta Derm Venereol. 2010;90:582–8.CrossRefPubMedGoogle Scholar
  21. 21.
    King RM, Wilson GV. Use of a diary technique to investigate psychosomatic relations in atopic dermatitis. J Psychosom Res. 1991;35:697–706.CrossRefPubMedGoogle Scholar
  22. 22.
    Buske-Kirschbaum A, Geiben A, Hellhammer D. Psychobiological aspects of atopic dermatitis: an overview. Psychother Psychosom. 2001;70:6–16.CrossRefPubMedGoogle Scholar
  23. 23.
    Dark K, Peeke HVS, Ellman G, Salfi M. Behaviorally conditioned histamine release. Prior stress and the conditionability and extinction of the response. Ann N Y Acad Sci. 1987;496:578–82.CrossRefPubMedGoogle Scholar
  24. 24.
    Scholz OB, Hermanns N. Krankheitsverhalten und Kognitionen beeinflussen die Juckreiz-Wahrnehmung von Patienten mit atopischer Dermatitis. Z Klin Psychol. 1994;23:127–35.Google Scholar
  25. 25.
    Niemeier V, Winckelsesser T, Gieler U. Hautkrankheit und Sexualität. Eine empirische Studie zum Sexualverhalten von Patienten mit Psoriasis vulgaris und Neurodermitis im Vergleich mit Hautgesunden. Hautarzt. 1997;48:629–33.CrossRefPubMedGoogle Scholar
  26. 26.
    Schneider G, Driesch G, Heuft G, Evers S, Luger TA, Ständer S. Psychosomatic cofactors and psychiatric comorbidity in patients with chronic itch. Clin Exp Dermatol. 2006;31:762–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol. 1998;139:846–50.CrossRefPubMedGoogle Scholar
  28. 28.
    Picardi A, Abeni D, Melchi CF, Puddu P, Pasquini P. Psychiatric morbidity in dermatological outpatients: an issue to be recognized. Br J Dermatol. 2000;143:983–91.CrossRefPubMedGoogle Scholar
  29. 29.
    Capoore HS, Rowland-Payne CME, Goldin D. Does psychological intervention help chronic skin conditions? Postgrad Med J. 1998;74:662–4.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag London 2016

Authors and Affiliations

  1. 1.Department of Psychosomatics and PsychotherapyUniversity Hospital Münster, University of MünsterMünsterGermany

Personalised recommendations